1. How long does the PRP treatment session take?
A PRP 'session' take 45 - 60 minutes
2. How often is it repeated?
After the first treatment, we do a booster PRP at 3 months followed by treatment sessions every 3-6 months (2-4 times yearly). All patients require a follow up appointment at 9 months (6 months after the second PRP treatment) to determine if the treatment is working.
In our opinion, there is yet to be any good evidence that more frequent treatments initially (i.e. monthly) are more effective. We understand all the algorithms that existing for doing PRP (i.e. month 1, 2, 3, and them every 4-6 month). We feel this approach is a balanced one.
3. What are the basic steps in doing PRP treatment at Donovan Medical?
1. Arrive at the office and meet with Dr. Donovan to complete your consent form (10 minutes)
2. Meet Dr. Donovan's nurse who will get you in a comfortable position and take 120 mL of blood (15 minutes).
3. The blood is placed in the Angel PRP system and spun down (centrifuged) - (25-30 minutes)
4. While the blood is being spun, your scalp will be numbed up (frozen) with local anesthetics
5. You will be allowed to sit and relax for 20-30 minutes while the machine spins the blood
6. After the machine has finished, the PRP is injected into your scalp by Dr. Donovan (5 minutes). 120 mL of blood taken in step 2 ultimately gives us approximately 17-20 mL of PRP for injection throughout the scalp - a volume we feel is essential in treating hair loss. Approximately 50-75 injections are done.
7. The scalp is then cleaned to make sure you leave the centre as similar as to when you entered. (5 minutes)
TOTAL TIME: 60 minutes
4. What do you do to limit pain during the procedure ?
We use lidocaine injections using a tiny needle. These are injected into the areas of hair loss and allowed to take effect for 20 minutes. The areas are then tested after 20 minutes and if more freezing is needed, it is administered.
5. Are numbing creams used?
We do not use numbing creams in our office. We have not found the use of EMLA and similar numbing creams alters the pain of injections. However, we have found that the use of vibration devices and by injecting slowly that the procedure is much less painful.
6. Do I need to stop my Rogaine, Laser or other treatments before my PRP treatment?
No, this is not necessary.
7. Is there a shedding period after a treatment?
Usually not. It's fairly rare to get significant shedding with PRP but ANY treatment that stimulates hair growth (minoxidil, finasteride, low level laser does have the potential to cause shedding).
8. How soon after the procedure can I wash my hair?
Most patients wash their hair the following morning. Please refer to our PRE and POST Procedure Steps
9. Does PRP work only if you take minoxidil (Rogaine) or finasteride (Propecia)?
No. PRP treatment is separate from minoxidil and fiansteride. You can potentially get benefits from PRP even if minoxidil and finasteride are not used. However, the combination of treatments usually works better than single treatments.
10. Does PRP help to just maintain what hair you have or improve density?
PRP can do both. Improvement in density is of course the goal we hope for.
11. Do you use Acell in your PRP treatment?
Physicians in Canada are NOT allowed to use Acell. It is not allowed in the country. Some physicians in other countries use Acell. There is no evidence that ACell use is better than not using
12. Is Propecia a better option for men with genetic balding than PRP?
No. Propecia is a more effective option but side effects are much greater.
13. Do you have any information on research in PRP for hair loss?
You may wish to review Dr. Donovan's previous article
14. How do I prepare for my PRP session?
Please review our PRP Pre and Post procedure Steps
15. What are the limitations AFTER my PRP procedure. For example, what can't I do?
The main limitations are to avoid aspirin, advil and alcohol. It's okay to exercise right after. Please refer to our PRE and POST Procedure Steps
16. What are the costs of PRP?
The following is the fee schedule for PRP Injections:
1 session: $ 1,500 + tax
2 session package: $ 2,800 + tax
4 session package: $ 5,500 + tax
17. What are the ongoing fees for PRP treatment?
Fees are typically $ 1500 every 4-8 months and fees of $ 650 if the patient requires a longer follow up appointment to discuss issues other than PRP (i.e. other oral or topical treatments, or blood tests or other issues unrelated to the PRP). There is no charge for the follow up appointment conducted at 9 months. The 9 month follow up appointment is conducted by Dr. Donovan and is an important appointment to determine if the treatment is working or not. Once it is determined that the PRP is indeed effective patients return every 4-8 months. Follow up appointments before each PRP treatment are 5-10 minutes in length and may be conducted by Dr. Donovan or his staff. The purpose of the follow up is to determine if there are any changes to the patient's health or any other circumstances that might necessitate pausing treatment and booking a full 20-30 minute follow up appointment.
18. I am doing PRP but want to talk to Dr. Donovan about my blood test results or whether I should change by medications or supplements. Should I book a follow up or can I talk to Dr. Donovan during my next PRP session?
Please contact our office first as it may be more appropriate to book a follow up appointment. Once it is determined that PRP treatments are helping, patients return every 4-8 months. The follow up appointment before the PRP treatment is assigned 5-10 minutes and is usually conducted by our office staff. They will ask about any changes to your health since your last appointment and any changes in medications. They will also enquire if you had any side effects with the last treatment. The purpose of the brief follow up before the PRP session actually starts is to determine if there are any changes to the patient's health or any other circumstances that might necessitate pausing treatment and booking a full 20-30 minute follow up appointment.
If the patient wishes to discuss issues with Dr. Donovan other than the PRP (i.e. other oral or topical treatments, or blood tests or other issues unrelated to the PRP) a 20-30 minute follow up appointment should be booked as the 5-10 minute follow up with the staff would not be appropriate in this situation. Follow up appointment fees of $ 650 apply in this situation and should be booked on a day separate from the PRP procedure day.
19. If I want to do PRP every 9-12 months instead of more frequently, does the clinic allow me to do this?
Yes. For some patients this may be all that is needed. For others, this may be far too infrequent. However, it is acceptable to do so with the understanding that this frequency of treatments may not be ideal.
20. If I want to do PRP every 1 to 2 months instead of less frequently, does the clinic allow me to do this?
Yes. Generally speaking, our studies have not supported a benefit of very closely spaced treatments for most patients. It may however, be beneficial to a small proportion.
21. I would like to come in to the office and watch a PRP procedure done. Is this possible?
To protect the privacy, this is not possible in our office.
22. If a patient does develop side effects, how long do they last?
Most patients do not develop significant side effects. However, if they do, side effects generally last less than 24 hours. The most common side effect is tenderness and this is typically present to a slight degree for the first 12 hours. Most patients have minimal tenderness the following day. Swelling is uncommon but if it occurs it lasts about 48-72 hours. Swelling of significant amount that is noticeable to another person is extremely uncommon. Some numbness in the scalp can occur for several hours and rarely patients have numbness lasting for 3-4 days.
23. How common is shock loss?
True shock loss refers to loss of hairs directly due to a perception of neighbouring follicles that there has been injury or trauma. This is rare in PRP in our centre. Shock loss occurs in about 1 in every 500 patients. It is important to note that this is different than hair shedding from the administration of a growth promoting agent. All treatments that actually stimulate hair growth can cause some shedding in the first 1-2 months. This is not shock loss.
24. In your office, who actually does the PRP injections?
The injections are performed solely by Dr. Donovan.